American Elephants

The Swine-Flu Mess, and Why It Is a Mess. by The Elephant's Child
November 1, 2009, 7:12 pm
Filed under: Health Care, Politics, Progressivism | Tags: , ,

You will have to admit that it is handy for the administration — when the nation is embroiled in a debate about government efforts to reform our health care system — to have the public concerned about getting swine-flu, and looking to the government for succor.

President Obama first declared the swine flu to be a Public Health Emergency back in April, and then on Friday, October 23, he declared it a National Emergency.  The first declaration allowed the shipment of flu-fighting medications from the federal stockpile. (There was no vaccine at the time).  The second declaration modifies hospital regulations so they can put treatment tents in parking lots and addresses financial questions for hospitals.

The Centers for Disease Control (CDC) estimates that on average through the 1990s about 36.000 people died of seasonal flu-related causes each year.  Flu-related means things like the flu turning into pneumonia, or the flu affecting someone whose underlying cause of death was a respiratory or circulatory disease.

The CDC estimates that only about a third of the samples that doctors or scared patients suspect may show swine flu (H1N1) actually test positive.  Some people may have swine flu, but with symptoms so mild that in previous years they would just have stayed home.  But panic has flooded doctors offices with the mildly ill or the worried well.  “Government,” Michael Fumento quotes H.L Menken,”ever seeks to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary.”

The administration estimated that 40,000 doses of H1N1 flu vaccine would be ready by November. So far only about half that many doses are available. What happened? Dr. Scott Gottlieb explains in the Wall Street Journal:

The first fateful decision, way last spring, was to forgo vaccine additives — called adjuvants— that activate the immune system and make shots more potent. Adjuvants allow a smaller supply of vaccine stock to be stretched across more doses.  These adjuvants  are included in H1N1 vaccines world-wide, but not in the U.S.

Why do adjuvants matter? An adjuvanted H1N1 vaccine being used in Europe contains 3.75 micrograms of vaccine stock.  The same vaccine in the U.S. , without the adjuvant, requires 15 micrograms of vaccine for equal potency.  If we used adjuvants, we could have had four times the number of shots with the same raw material.

The second cautious decision was to require that the H1N1 vaccine be a single shot. (…)

The third policy decision was to stick for too long with a proven, but slow process for making flu shots that uses chicken eggs to grow the raw vaccine material.

Dr. Gottlieb, a practicing physician who was deputy commissioner of the FDA from 2005 to 2007,  has some suggestions for improving our regulatory process to prevent such shortages.  Read the whole article here.

Nine weeks ago, the President’s Council of Advisors on Science and Technology issued its report with a “plausible scenario” of 30,000 to 90,000 deaths  peaking in “mid-October.  Best counts so far (CDC no longer releases specific swine flu case death numbers) is about 1.100.

Pregnant women and children under 4 are the most vulnerable, along with children 5 to 18 with chronic medical problems such as asthma and diseases of the heart and liver.  But swine-flu problems are clearly much less than with the regular seasonal flu.  Vaccine production is being stepped up.

The Defense Department has announced that detainees at Guantanamo Bay, Cuba, are considered to be at higher risk, and will thus be offered the H1N1 vaccine.  It would obviously be politically incorrect to chance any of the detained terrorists at Gitmo contracting the swine flu.

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